Central serous chorioretinopathy associated with nonspecific orbital inflammation: a case report.

We herein present a rare case of acute central serous chorioretinopathy (CSC) associated with nonspecific orbital inflammation (NSOI). A 38-year-old woman presented with a 3-day history of ocular pain, reduced vision, periorbital swelling, proptosis, conjunctival chemosis, and restricted eye movements. Optical coherence tomography of the affected eye confirmed signs of CSC. Additionally, a computed tomography scan revealed enlargement of intraconal soft tissues and the lacrimal gland. Ocular ultrasonography detected posterior sclera thickening, indicating posterior scleritis. Following the diagnosis of NSOI, the patient received treatment with systemic corticosteroids, resulting in gradual regression of both the orbital inflammation and CSC. This is the first reported case of localized posterior pole CSC documented in a patient with NSOI. Vigilant monitoring for any ocular disorders is important in patients with orbital inflammation.

Therapeutic Effects of Tamsulosin in Nightmare Disorder: A Randomized, Double Blind, Placebo-Controlled, Cross-Over, Pilot Study.

Nightmare disorder is associated with functional impairment, distress, and low quality of life; however, studies on pharmacotherapy of this debilitating disorder yielded mixed results. Prazosin, a non-selective α1 blocker is reported to be effective in treatment of post-traumatic stress disorder-related nightmares. We aimed at investigating therapeutic effects of tamsulosin which has higher affinity for blocking α1A and α1D adrenoceptors in treatment of nightmare disorder. A randomized, double blind, cross-over, placebo-controlled pilot study was conducted. Patients were randomly assigned to receive Tamsulosin 0.4 mg once daily or placebo for period of four weeks. Following a 2-week wash-out period, they were crossed over to the other group and received drug or placebo for duration of 4 additional weeks. Nightmare frequency and intensity measurements were carried out using Disturbing Dreams and Nightmares Severity Index (DDNSI). Blood pressure measurements were also performed. According to per protocol analysis, mean DDNSI scores decreased following administration of tamsulosin and a statistical trend towards significance was reported (p=0.065, d=0.236). Results of intention to treat analysis showed significant difference in DDNSI scores after drug use (p=0.030, d=0.651). Additionally, DDNSI scores dropped significantly following placebo use. However, intention to treat analysis showed no statistically significant difference pre and post placebo period (0.064, d=0.040). Tamsulosin may be effective in treatment of nightmare disorder. However, further larger clinical trials are recommended to clarify the effectiveness of tamsulosin and α1 subtypes in pharmacotherapy of nightmares.

Demographic and biological factors in interrelationships between physical, cognitive, psychological, and social frailty in community-dwelling older adults: Data from the Birjand Longitudinal Aging Study (BLAS).

Complex interrelationships may exist among different types of frailty. This study aimed to evaluate the demographic and biological factors that influence the different types of frailty in community-dwelling older adults in Iran through a cross-sectional analysis of data obtained from the Birjand Longitudinal Aging Study. This study is an ongoing cohort study of people aged 60 years and over and employed a multistage stratified cluster random sampling. Anthropometric measures were obtained by nurses. The "Fried frailty phenotype" was defined as physical frailty. Cognitive frailty was assessed using the Mini-Mental State Examination. Social frailty was evaluated by some questions, and psychological frailty was assessed using a patient health questionnaire. Blood samples were taken after overnight fasting. All statistical analyses were performed using Stata12 (Texas, USA) and Python. Some type of frailty had been experienced by 62.27 % of the older adults. Cognitive frailty was the dominant type of frailty (55.69 %). Based on multivariate regression analysis, age, sex, education, and marital status were the influencing factors in all types of frailty. Network analysis revealed that physical, cognitive, psychological, and social frailty had synergistic effects on each other, and age and sex had dominant interactions with frailty types. Cognitive frailty was dominant compared with other types of frailty, indicating the need to detect cognitive frailty at the earliest stage and to implement an appropriate program to manage cognitive frailty in older adults.

Effects of kisspeptin on the maturation of human ovarian primordial follicles in vitro.

At this time, with advances in medical science, many cancers and chronic diseases are treatable, but one of their side effects is infertility. Some women also want to delay pregnancy for personal reasons. There has been some evidence that kisspeptin activates broad signals by binding to its receptor, suggesting that the role of kisspeptin in direct control of ovarian function includes follicle growth and steroid production. In this study, the effect of kisspeptin on improving the quality and results for human ovarian follicles was investigated. A section of ovary was removed laparoscopically from women between 20 and 35 years of age (n = 12). Pieces were divided randomly into two groups, control and treatment (with 1 µM kisspeptin). Real-time PCR was performed for GDF9, BMP15 and mTOR gene expression assessments. Western blotting was carried out to measure AKT and FOXO3a protein expression. Data were analyzed using one-way analysis of variance (ANOVA) and Tukey's test; means were considered significantly different at a P-value < 0.05. During treatment with the kisspeptin group, maturity genes are expressed. Therefore, kisspeptin is an effective substance to improve the quality of the human ovarian medium as it increases the maturity of follicles.

Walking and running roll-off characteristics in patients with ACL reconstruction history.

BACKGROUND: Gait mechanics alternation is one of side effects after anterior cruciate ligament reconstruction (ACLR). Foot roll-off characteristics shows whole gait mechanics and is not well known in ACLR patients. The purpose of present study was to investigate the roll-off process characteristics while walking and running in patients with ACLR history. RESEARCH QUESTION: Is there any difference in walking and running roll-off characteristics between patients with ACLR history and healthy individuals? METHODS: 48 physically active males (24 healthy and 24 with ACLR history) participated in this study. Participants walked and ran on a footscan (Rsscan International) which was mounted in the midway of a 18 m runway at the speeds of 2 m·s-1 and 3.3 m·s-1. Center of pressure (COP) trajectory, timing of stance subphases, foot progression angle and contact time were calculated bilaterally in walking and running. Mixed-design MANOVA was used to examine effect of ACLR on the outcomes. RESULTS: The results showed that ACLR participants had greater foot progression angle (p = .001) and more medially oriented COP trajectory in forefoot push-off phase (FFPOP) of waking (p = .001) and running (p = .001), but showed shorter contact time in running compared to healthy group (p = .02). Involved leg in ACLR group showed greater foot progression angle (p = .001) and more medially directed COP trajectory in FFPOP of walking (p = .001) and running (p = .01) compared to uninvolved side. Also, involved leg had shorter contact time (p = .04) and shorter relative time in the forefoot contact phase (p = .001), and longer relative time in forefoot flat phase (p = .001) during running. SIGNIFICANCE: Based on the results, it can be concluded that ACLR affects running and walking roll-off characteristics which can show altered mechanics. Running shows remarkable differences in roll-off process than walking. So, it is recommended to use running in post-ACLR assessments rather than walking.

Prevalence of HIV, hepatitis B virus, hepatitis C virus, drug use, and sexual behaviors among street children in Iran: A systematic review and meta-analysis.

Background and Aims: Street children face a disproportionately higher risk of human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) due to high-risk sexual and drug use practices. We aimed to estimate the prevalence of these infections and related risk behaviors among street children in Iran. Methods: We searched PubMed, Web of Science (ISI), Embase, Scopus, and Google Scholar for the English-language records and Iranian databases, including SID, Magiran, and IRANDOC for the Farsi-language records up to September 18, 2022. Random effects analysis was used to obtain prevalence estimates for each condition. Homogeneity across included studies was assessed using I 2. Results: We extracted data from 18 eligible studies, representing 5646 children (83.2% boys), with a mean age of 10.2 (range: 5-18). The prevalence of HIV, HBV, and HCV were 0.79% (95% confidence intervals [CIs]: 0.0-5.56), 1.97% (95% CI: 1.01-3.19), and 1.88% (95% CI: 0.74-3.46), respectively. The prevalence of lifetime drug use and sexual abuse was 8.32% (95% CI: 4.83-12.62) and 10.18% (95% CI: 3.02-20.67) among street children, respectively. Conclusion: The estimated prevalence of HIV, HBV, and HCV among street children in Iran was higher than the estimates in the general population. Moreover, drug use and the experience of sexual abuse were prevalent among this population. These findings suggest the need for targeted prevention programs for street children in Iran.

Transplantation of adipose derived stem cells in diabetes mellitus; limitations and achievements.

Objectives: Diabetes mellitus (DM) is a complex metabolic disease that results from impaired insulin secreting pancreatic ß-cells or insulin resistance. Although available medications help control the disease, patients suffer from its complications. Therefore, finding effective therapeutic approaches to treat DM is a priority. Adipose Derived Stem Cells (ADSCs) based therapy is a promising strategy in various regenerative medicine applications, but its systematic translational use is still somewhat out of reach. This review is aimed at clarifying achievements as well as challenges facing the application of ADSCs for the treatment of DM, with a special focus on the mechanisms involved. Methods: Literature searches were carried out on "Scopus", "PubMed" and "Google Scholar" up to September 2022 to find relevant articles in the English language for the scope of this review. Results: Recent evidence showed a significant role of ADSC therapies in DM by ameliorating insulin resistance and hyperglycemia, regulating hepatic glucose metabolism, promoting ß cell function and regeneration, and functioning as a gene delivery tool. In addition, ADSCs could improve diabetic wound healing by promoting collagen deposition, inhibiting inflammation, and enhancing angiogenesis. Conclusion: Overall, this literature review revealed the great clinical implications of ADSCs for translating into the clinical setting for the treatment of diabetes. However, further large-scale and controlled studies are needed to overcome challenges and confirm the safety and optimal therapeutic scheme before daily clinical application. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-023-01280-8.

Core decompression combined with local DFO administration loaded on polylactic glycolic acid scaffolds for the treatment of osteonecrosis of the femoral head: a pilot study.

BACKGROUND: Deferoxamine (DFO) angiogenesis induction potential has been demonstrated in earlier studies, but not in the osteonecrosis of the femoral head (ONFH). In this study, we evaluated the outcome of ONFH treated with combined core decompression and local DFO administration loaded on Polylactic Glycolic Acid (PLGA). PATIENTS AND METHODS: In a pilot experimental study, six patients (10 hips) with early-stage non-traumatic ONFH were treated by core decompression, and concurrent injection of local DFO loaded on PLGA scaffold into the subchondral femoral head. Outcome measures were evaluated before the surgery and 12 and 24 months after the surgery and included visual analog scale (VAS) for pain, modified Merle d'Aubigné-Postel (MAP) score for hip function by MRI, and rate of osteonecrosis assessed by the modified. RESULTS: The mean MPA score was 14.7 ± 1.16 before the surgery and 16.7 ± 1.41 one year after the surgery (P = 0.004). The mean VAS for pain was 4.7 ± 1.25 before the surgery and 1.8 ± 1.03 one year after the surgery (P = 0.005). The mean Kerboul angle was 219 ± 58.64 before the operation and 164.6 ± 41.82 one year after the operation (P < 0.001). Osteonecrosis progression or collapse was not seen in any of the patients at the final follow-up. No postoperative side effect attributed to the DFO was noticed, as well. CONCLUSION: In short-term follow-up, combined core decompression and local DFO administration not only prevent the progression of ONFH but also reduces the rate of osteonecrosis significantly. However, future controlled studies are required to confirm the present results. TRIAL REGISTRATION: IRCT20161121031003N3, 16/04/2019.

Prevalence of Compartment Syndrome and Disseminated Intravascular Coagulation following Rhabdomyolysis; a Systematic Review and Meta-Analysis.

Abstract. Introduction: Rhabdomyolysis (RM) may cause some complications such as compartment syndrome and disseminated intravascular coagulation (DIC), which can affect its prognosis. This systematic review and meta-analysis aimed to investigate the prevalence of the mentioned complications following RM. Methods: Medline, Embase, and Scopus databases were searched using keywords related to compartment syndrome, DIC, and rhabdomyolysis with appropriate combination. Cohort and cross-sectional studies that conducted research on the prevalence of compartment syndrome and DIC in patients with RM were included in the present study. The desired data were extracted from the included studies and meta-analysis was conducted on them to calculate pooled prevalence of these complications. Results: Twenty articles were included in our systematic review. The rate of compartment syndrome reported in these studies ranged from 0 to 30.7%. Our meta-analysis revealed the pooled prevalence of 4% (95% confidence interval (CI): 2.20 to 7.40) for compartment syndrome in these studies. The pooled prevalence of this complication was 7.1% (95% CI: 2.90 to 16.00) among patients with severe RM and 4.4% (95% CI: 1.80 to 10.00) in traumatic RM. The rate of DIC reported in the included studies ranged from 0 to 40.47%. Our meta-analysis showed the pooled prevalence of 8.3% (95% CI: 03.90 to 16.50) for this complication among RM patients. Conclusion: We reported the rates of compartment syndrome and DIC in RM patients based on rhabdomyolysis etiologies through an epidemiologic systematic review and meta-analysis. The rate of compartment syndrome was slightly higher in patients with severe RM and its rate in patients with traumatic RM was close to the overall rate of compartment syndrome.

Barriers and Problems in Implementing Health-Associated Infections Surveillance Systems in Iran: A Qualitative Study.

Background: Healthcare-associated infections (HAIs) are among the most critical challenges for patients and healthcare providers. To achieve the goals of the surveillance system, it is necessary to identify its barriers and problems. This study aimed to identify the barriers and problems of the surveillance system for HAIs. Methods: This qualitative study was conducted using the content analysis method to investigate the challenges of this surveillance system from the perspective of 18 infection control nurses from hospitals in different cities of Iran with work experience of 1 to 15 years. Data were collected through semi-structured interviews and analyzed using the Lundman and Graneheim qualitative content analysis method. Results: In this study, we found 2 categories and 7 subcategories. Two categories were barriers related to human resources and organizational barriers to infection control. The 7 subcategories included weakness of medical staff in adherence to health principles, obstacles related to patients, high workload and insufficient motivation, lack of staff knowledge, lack of human resources, functional and logistical weaknesses, and weaknesses in the surveillance system. Conclusion: To reduce problems and improve HAIs reporting, the HAIs surveillance system needs the support of health system officials and managers. This administrative and support focus can establish the framework for removing and lowering other barriers, such as the number of reported cases, physician and staff noncooperation, and the prevalence of HAIs. It can also bring HAIs cases closer to reality.

Ocular Trauma in Children: An Epidemiological Study.

OBJECTIVES: This study aimed to determine the epidemiology of eye injuries in children and the influential factors involved. METHODS: Eighty cases of confirmed ocular trauma were included in this cross-sectional study. Data were obtained via a checklist containing demographic information, site of the insult, the interval between the injury and physician visit, trauma mechanism, and medical history, including previous history of ocular trauma. RESULTS: Among 80 children with ocular trauma, 72.5% (n = 58) were boys. A marked preponderance (46.2%) of injuries was seen in the age group younger than 6 years. The youngest patient was a 1-year-old, and the oldest was aged 17. Most (76.25%) of the incidents occurred indoors. A total of 67.5% of accidents were induced by sharp objects (knife and glass). Most accidents occurred in spring, whereas the least number of accidents occurred in winter. The corneoscleral laceration was the most common manifestation, followed by the laceration of the iris, uveal prolapse, hyphema, and cataracts. Furthermore, rare cases of retinal detachment, hypopyon, and corneal epithelial defects were seen. CONCLUSIONS: The highest incidents of ocular trauma occurred in boys, especially those younger than 6 years. The high number of sharp object injuries is also concerning. These findings provide us with evidence that further educational interventions and supervision are required in these groups to minimize the possible devastating injuries before the opportunity even arises.

Restoring the Angiogenic Capacity of the Human Diabetic Adipose-derived mesenchymal stem cells Primed with Deferoxamine as a Hypoxia Mimetic Agent: Role of HIF-1α.

Purpose: Insufficient angiogenesis is associated with serious diabetic complications. Recently, adipose-derived mesenchymal stem cells (ADScs) are known to be a promising tool causing therapeutic neovascularization. However, the overall therapeutic efficacy of these cells is impaired by diabetes. This study aims to investigate whether in vitro pharmacological priming with deferoxamine, a hypoxia mimetic agent, could restore the angiogenic potential of diabetic human ADSCs. Methods: Diabetic human ADSCs were treated with deferoxamine and compared to normal and nontreated diabetic ADSCs for the expression of hypoxia inducible factor 1-alpha (HIF-1α), vascular endothelial growth factor (VEGF), fibroblast growth factor-2 (FGF-2) and stromal cell-derived factor-1α (SDF-1α), at mRNA and protein levels, using qRT-PCR, western blotting and ELISA assay. Activities of matrix metalloproteinases (MMPs)-2 and -9 were measured using a gelatin zymography assay. Angiogenic potentials of conditioned media derived from normal, Deferoxamine treated, and non-treated ADSCs were determined by in vitro scratch assay and also three-dimensional tube formation assay. Results: It is demonstrated that deferoxamine (150 and 300 µM) stabilized HIF-1α in primed diabetic ADSCs. At the concentrations used, deferoxamine did not show any cytotoxic effects. In deferoxamine treated ADSCs, expression of VEGF, SDF-1α, FGF-2 and the activity of MMP-2 and MMP-9 were significantly increased compared to nontreated ADSCs. Moreover, deferoxamine increased the paracrine effects of diabetic ADSCs in promoting endothelial cell migration and tube formation. Conclusion: Deferoxamine might be an effective drug for pharmacological priming of diabetic ADSCs to enhance the expression of proangiogenic factors noted via HIF-1α accumulation. In addition, impaired angiogenic potential of conditioned medium derived from diabetic ADSCs was restored by deferoxamine.

Cogan's Lid Twitch for Myasthenia Gravis: A Systematic Review.

INTRODUCTION: Myasthenia gravis is an autoimmune condition affecting the neuromuscular junction of skeletal muscles and may be difficult to diagnose. Several clinical signs may have diagnostic utility, including Cogan's lid twitch. This systematic review aims to synthesise the literature on the accuracy of Cogan's lid twitch for diagnosing myasthenia gravis. METHODS: A systematic search of the databases PubMed/MEDLINE, Embase and CENTRAL was performed from inception to August 2022. Risk of bias analysis and data extraction were performed in accordance with the PRISMA 2020 guidelines. RESULTS: Seven articles satisfied the inclusion criteria. The results showed that for the diagnosis of myasthenia gravis, Cogan's lid twitch has a sensitivity between 50% and 99% and specificity between 75% and 100%. CONCLUSIONS: Cogan's lid twitch is a physical examination finding with moderate diagnostic performance in the diagnosis of myasthenia gravis with ocular involvement. Future studies may seek to evaluate the performance of Cogan's lid twitch in conjunction with other signs of myasthenia gravis with ocular involvements, such as fatigable ptosis or a positive icepack test.

Generation of Haploid Spermatids on Silk Fibroin-Alginate-Laminin-Based Porous 3D Scaffolds.

In vitro production of sperm is a desirable idea for fertility preservation in azoospermic men and prepubertal boys suffering from cancer. In this study, a biocompatible porous scaffold based on a triad mixture of silk fibroin (SF), alginate (Alg), and laminin (LM) is developed to facilitate the differentiation of mouse spermatogonia stem cells (SSCs). Following SF extraction, the content is analyzed by SDS-PAGE and stable porous 3D scaffolds are successfully prepared by merely Alg, SF, and a combination of Alg-SF, or Alg-SF-LM through freeze-drying. Then, the biomimetic scaffolds are characterized regarding the structural and biological properties, water absorption capacity, biocompatibility, biodegradability, and mechanical behavior. Neonatal mice testicular cells are seeded on three-dimensional scaffolds and their differentiation efficiency is evaluated using real-time PCR, flow cytometry, immunohistochemistry. Blend matrices showed uniform porous microstructures with interconnected networks, which maintained long-term stability and mechanical properties better than homogenous structures. Molecular analysis of the cells after 21 days of culture showed that the expression of differentiation-related proteins in cells that are developed in composite scaffolds is significantly higher than in other groups. The application of a composite system can lead to the differentiation of SSCs, paving the way for a novel infertility treatment landscape in the future.

Incidence, accuracy, and barriers of diagnosing healthcare-associated infections: a case study in southeast Iran.

BACKGROUND: Healthcare-associated infections (HAIs) are a threat to patients. Accurate surveillance is required to identify and prevent HAIs. To estimate the incidence rate, report the accuracy and identify the barriers of reporting HAIs using a mixed-method study. METHODS: In this quantitative study, we externally evaluated the incidence rate and accuracy of the routine surveillance system in one of the main hospitals by an active follow-up of patients from September to December 2021. We used in-depth interviews with 18 experts to identify the barriers of the routine surveillance system. RESULTS: Among 404 hospitalized patients, 88 HAIs were detected. The estimated rate of HAIs was 17.1 (95% Confidence Intervals 95: 14.1, 21.1) per 1000 patient-days follow-up. However, in the same period, 116 HAIs were reported by the routine surveillance system, but the agreement between the two approaches was low (sensitivity = 61.4%, specificity = 82.6%, negative predictive value = 89.7%, and positive predictive validity = 46.5%). The minimum and maximum positive predictive values were observed in urinary tract infection (32.3%) and surgical site infection (60.9%). The main barrier of reporting HAIs was lack of cooperation in reporting HAIs by infection control link nurses and laboratory supervisors. CONCLUSIONS: The discrepancy between the longitudinal study findings and the routine surveillance might be related to the inaccessibility of the surveillance system to clinical information of patients. In this regard, decreasing the barriers, increasing the knowledge of infection control nurses and other nurses, as well as the development of hospital information systems are necessary.

Myopia Progression during the COVID-19 Era: A Systematic Review and Meta-analysis.

BACKGROUND: To evaluate myopia progression during the novel coronavirus disease 2019 (COVID-19) pandemic and its risk factors. METHODS: We searched PubMed, Scopus, and Web of Science to find literature until August 2022 related to COVID-19 pandemic and myopia progression. Outcomes of myopia progression included axial length (AL) and spherical equivalent (SE). Factors of screen time and outdoor activity time were analyzed. RESULTS: Thirty-three studies were included in this meta-analysis. Compared to the same period before the COVID-19 pandemic, myopia prevalence increased (OR = 1.11; 95% CI, 1.05-1.18). The outcomes of SE decreased -0.61 diopter (95% CI, -0.98 to -0.23), and AL increased 0.42 mm (95% CI, 0.13-0.7). Mean screen time was increased 6.25 hours/day (95% CI, 4.84-7.66), and outdoor activity time was decreased -1.52 hours/day (95% CI, -3.20 to -0.15). CONCLUSION: Establishing care policies is necessary to restrict behavioral changes and their consequences during the pandemic.

Extruded biocomposite films based on poly(lactic acid)/chemically-modified agricultural waste: Tailoring interface to enhance performance.

In this work, a lignocellulosic filler, rice straw (RS), was thermoplasticized by acetylation modification process and compounded with plasticized poly(lactic acid) (PLA) through twin-screw extrusion process. The biocomposite films were prepared continuously by using a slit die for PLA/RS and PLA/acetylated RS (ARS) compounds. By the chemical reaction, thermoset microstructure of RS was changed to a more flexible one. Additionally, by the reaction, the interfacial adhesion of lignocellulosic filler/PLA matrix, filler hydrophobicity and PLA wettability was enhanced considerably. The miscibility of partially phase-separated PLA/poly(ethylene glycol) (PEG) mixtures was improved by adding RS-based microfillers, particularly by the acetylated RS. Compared with PLA/unmodified RS films, PLA/ARS biocomposites show better thermal stability, toughness, Young modulus and softening point, especially at certain filler loadings.

Utilization of smartphones for the evaluation of Gr/Ni nanostructures magnetically controlled based on optical fibers surface plasmons.

In the suggested optical fiber-based magnetoplasmonic system, we investigated the magnetic properties of graphene/nickel nanostructures. The plasmonic mode changes under the magnetic field observed in the intensity diagrams over time. To be accessible, cheap, and portable, we used a smartphone as a detector and processor. Considering the ambient noise and the light source, it was reported that the intensity of the changes improved up to 5 times. Further, the clad corrosion experiment carried out by pure dimethyl ketone in an intensity modulation by a smartphone camera and 10 seconds suggested removing fluorine polymer clad.

Opium Use and the Risk of Cataract: a Hospital-based, Group-matched, Case-control Study in Iran.

PURPOSE: Cataract is the most prevalent cause of reversible blindness worldwide. Although studies have identified risk factors for cataract, its association with opium use has not been studied. This study aimed to evaluate the association between opium use and cataract in Iran in 2020. METHODS: In a hospital-based, group-matched case-control study in Kerman, a city in southeast Iran, 160 new cases of cataract and 320 controls without cataract underwent ophthalmological examination and were interviewed. Logistic regression models tested the association between cataract and history of opium use, adjusting for demographic characteristics and history of hypertension, coronary heart disease, renal disease, smoking, alcohol use, and unprotected sun exposure. RESULTS: After controlling for potential confounders, opium use increased the odds of cataract, exhibiting a dose-response relationship. The adjusted odds ratio (aOR) for mild use was 1.44 (95% confidence intervals [CI] 0.80-2.58), and 2.10 (95% CI 1.04-4.25) for heavy use. Exposure to opium juice use further increased the odds of cataract (aOR 2.24, 95% CI 1.00-5.10). Other significant associations with cataract were lower education level (aOR 5.46, 95% CI 2.45-11.29), being unmarried (aOR 2.88, 95% CI 1.65-5.00), both underweight (BMI <18.5, aOR 5.27, 95% CI 2.02-13.70) and overweight (BMI >25, aOR 1.82, 95% CI 1.15-2.87), and family history of cataract (aOR 2.07, 95% CI 1.32-3.23). CONCLUSION: Our study provides evidence that opium use could increase the odds of cataract. Results also support the association of cataract with other modifiable risk factors, such as very low and high BMI and unprotected sun exposure.